Boy (4) left in hospital for over two years due to Tusla and HSE failings, report says

‘Distressed’ child was medically fit for discharge, children’s ombudsman says

Dr Niall Muldoon, Ombudsman for Children. Photograph: Dara Mac Dónaill

Dr Niall Muldoon, Ombudsman for Children. Photograph: Dara Mac Dónaill


A four-year-old boy was left in hospital for more than two years, despite being medically fit for discharge, due to failings by the HSE and Tusla, a report published on Thursday finds.

The report from the Ombudsman for Children’s Office, finds the “actions” of the two organisations had a “negative impact” on the life of the boy and that he was discriminated against due to his disability. At least 365 other children with disabilities are stuck in hospital because they cannot get the appropriate supports to go home safely, it adds.

The boy, who is named “Jack” in the report, was three when he sustained catastrophic injuries in a car crash abroad in 2016. He was diagnosed with an array of physical disabilities, a profound intellectual disability and he would require full assistance with all aspects of his daily care.

He returned to Ireland in 2017, was admitted straight into hospital and was ready for discharge in August 2017.

However, he “remained living between two hospitals and a specialist community respite setting for 2½ years due to the failure of HSE disability services and Tusla to work individually and together to meet his needs,” the report states.

“During that time there were periods where Jack had no educational supports and was essentially isolated from contact with other children. He rarely saw his younger sister.”

There were weeks when “Jack reportedly presented as distressed and was crying constantly”.

No response

In May 2017, in preparation for discharge, the hospital referred Jack to his local HSE disability services. In October there remained no response from the HSE. In January 2018, still with no response, the hospital complained to the ombudsman.

In April 2018 a social worker made a referral to Tusla, as Jack’s mother believed she would not be able to care for him properly along with his sibling at home. Throughout 2018 and 2019 Tusla asserted Jack’s case was not a child protection or welfare one and was solely for HSE disability services.

In February 2020 Jack was formally placed with a host family by the HSE under the auspices of a charitable organisation, though without a clear legal basis for the placement.

He remains with the host family and both agencies, his mother and the family are working together to meet his needs and plan for his future.

Among the ombudsman’s findings are that the agencies’ actions “had a negative impact on the boy’s life”. There were “systemic failures” by the HSE to provide adequate support, while Tusla acted in a “discriminatory” way.

Review urged

Ombudsman Dr Niall Muldoon said: “If the HSE and Tusla had worked together at an early stage Jack may have had the opportunity, with adequate support, to grow up with his family. Even if it was not possible for him to return home, he could have been moved sooner to a more homely environment and even gone to school”.

His report calls on the HSE to “immediately and systemically review all cases where a child remains in hospital settings beyond their medical need” and engage with the Department of Health to ensure services to support children with disabilities to grow up at home with their families.

Tusla chief executive Bernard Gloster said the agency accepted the report’s findings and recommendations in full. Among these is that all social workers be issued with guidance that protection and welfare referrals about children with disabilities be assessed and managed in the same way as all other referrals.